Registration for Professionals

If you are a professionally licensed esthetician or massage therapist in any state, or you are the owner or operator of a spa with licensed personnel, you can apply for the Professional Registration with Elixer of Life.

The Professional registration is an agreement between the applicant and Elixer of Life. The terms of the agreement are that the applicant can receive the following discount, opportunity and commission:

1) You can have your clients purchase any of the Personal Line products (not Professional) directly from us at a 15% discount to the advertised price, and you will receive a commission - if your code is used at time of purchase - for 25% of the total amount spent excluding taxes and shipping.

CONTACT INFORMATION

Please complete all questions in this section.

Name

First Name

Last Name

Phone

(###)

###

####

LICENSE INFORMATION

You must fill out one section below, either (a), (b), or (c) below, as well as the remaining questions.

(a) Esthetician License Number

(b) Massage License Number

State Licensed In

Please select the State you are licensed in, or if you are licensed in another country or territory, select "Other" and write the country or territory in the area below.

Other (Region or Country)

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